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BMA considers vote of no confidence in Andrew Lansley

Doctors are frustrated that they are being ignored. “Top-down reorganisation” is exactly what this l

The British Medical Association (BMA) – the professional body representing doctors – is to debate a vote of no confidence in the Health Secretary, Andrew Lansley, amid mounting anger about his plans to restructure the NHS.

An emergency general meeting has been called for next week. Several motions highly critical of the Health Secretary will be discussed.

The BMA's biggest branch, its London regional council, has submitted a motion seeking a vote of no confidence. Another, from the Buckinghamshire branch, calls for the same, on the basis that Lansley has reneged on a pre-election promise to end "top-down reorganisation of the NHS" and has pursued reform despite no evidence that either patient care or NHS finances will be improved.

Birmingham doctors make the same point, in markedly angry language, saying that one "would not buy a used car off someone who had trumpeted no 'top-down' reorganisation of the NHS prior to being elected and then proceeds to introduce a massive and clearly long-planned reorganisation of the NHS after being elected".

Much of this frustration arises from doctors feeling that their concerns are being ignored by the Health Secretary. In January the BMA chairman, Dr Hamish Meldrum, voiced concerns that Lansley had not responded directly to the organisation's detailed and constructive criticisms of the Health Bill.

Dr Kevin O'Kane, chairman of the BMA's London region, explains the move thus:

The BMA has until now attempted to have dialogue with the Health Secretary since he released his NHS reform white paper last summer. But unfortunately Andrew Lansley has totally ignored our concerns and has behaved in a high-handed fashion with the concerns of the BMA, other health unions, the medical royal colleges, patients' groups and health think tanks.

The proposed reforms have been controversial, to say the least, with David Cameron employing a new adviser to keep an eye on NHS policy. After private meetings with Lansley, the Prime Minister has decided to stand by the policy. However, it is cause for concern if the voices of the professionals who will be affected are ignored, particularly given that Cameron wrote just last month that the "big society" means "putting trust in professionals and power in the hands of the people they serve".

In practice, if a vote of no confidence were passed, it would further dilute the BMA's capacity to influence the policy. But that it is even under discussion is a sign of huge frustration within the medical profession. The government would do well to engage with these dissenting voices in order to make reform more workable, rather than shut them out altogether. "Top-down reorganisation" is exactly what this looks like.